头脑风暴：一项评估在获得性脑损伤（ABI）中同时进行脑刺激（tDCS）和工作记忆训练对认知表现影响的随机双盲临床试验的研究方案。

BRAINSTORMING: A study protocol for a randomised double-blind clinical trial to assess the impact of concurrent brain stimulation (tDCS) and working memory training on cognitive performance in Acquired Brain Injury (ABI).

机构信息

Visual Experience Laboratory, School of Psychology, University of Birmingham, Birmingham, UK.

Center for Human Brian Health (CHBH), University of Birmingham, Birmingham, UK.

出版信息

BMC Psychol. 2020 Nov 26;8(1):125. doi: 10.1186/s40359-020-00454-w.

DOI:10.1186/s40359-020-00454-w

PMID:33243286

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7694939/

Abstract

BACKGROUND

Acquired Brain Injury (ABI) admissions have an incidence of 385 per 100,000 of the population in the UK, and as brain injury often involves the frontal networks, cognitive domains affected are likely to be executive control, working memory, and problem-solving deficits, resulting in difficulty with everyday activities. The above observations make working memory, and related constructs such as attention and executive functioning attractive targets for neurorehabilitation. We propose a combined home-based rehabilitation protocol involving the concurrent administration of a working memory training program (adaptive N-back task) with non-invasive transcranial direct current stimulation (tDCS) of the right dorsolateral prefrontal cortex to promote long-lasting modification of brain areas underlying working memory function.

METHOD

Patients with a working memory deficit will be recruited and assigned to two age-matched groups receiving working memory training for 2 weeks: an active group, receiving tDCS (2 mA for 20 min), and a control group, receiving sham stimulation. After the end of the first 2 weeks, both groups will continue the working memory training for three more weeks. Outcome measures will be recorded at timepoints throughout the intervention, including baseline, after the 2 weeks of stimulation, at the end of the working memory training regimen and 1 month after the completion of the training.

DISCUSSION

The aim of the study is to assess if non-invasive tDCS stimulation has an impact on performance and benefits of a working memory training regimen. Specifically, we will examine the impact of brain stimulation on training gains, if changes in gains would last, and whether changes in training performance transfer to other cognitive domains. Furthermore, we will explore whether training improvements impact on everyday life activities and how the home-based training regimen is received by participants, with the view to develop an effective home healthcare tool that could enhance working memory and daily functioning.

TRIAL REGISTRATION

This study was registered with clinicaltrials.gov: NCT04010149 on July 8, 2019.

摘要

背景

在英国，每 10 万人中就有 385 人患有获得性脑损伤（ABI），由于脑损伤通常涉及额网络，受影响的认知领域可能是执行控制、工作记忆和解决问题的缺陷，导致日常活动困难。上述观察结果使工作记忆以及注意力和执行功能等相关结构成为神经康复的有吸引力的目标。我们提出了一种基于家庭的联合康复方案，包括同时进行工作记忆训练计划（自适应 N 回任务）和右背外侧前额叶皮层的非侵入性经颅直流电刺激（tDCS），以促进与工作记忆功能相关的大脑区域的持久改变。

方法

将招募有工作记忆缺陷的患者并将其分配到两个年龄匹配的组中，接受为期 2 周的工作记忆训练：一个是主动组，接受 tDCS（2 mA 持续 20 分钟），另一个是对照组，接受假刺激。在第一阶段的 2 周结束后，两组将继续进行 3 周的工作记忆训练。将在整个干预过程中的各个时间点记录结果测量，包括基线、刺激后 2 周、工作记忆训练方案结束时和训练完成后 1 个月。

讨论

该研究的目的是评估非侵入性 tDCS 刺激是否对工作记忆训练方案的表现和收益有影响。具体而言，我们将研究大脑刺激对训练收益的影响，如果收益变化持续，以及训练表现的变化是否会转移到其他认知领域。此外，我们将探讨训练改善是否会对日常生活活动产生影响，以及基于家庭的训练方案如何被参与者接受，以期开发出一种有效的家庭保健工具，以增强工作记忆和日常功能。